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eVI <br /> e print or type,(Form desIgned for use on eke(i2-pitch) vriter) Fop: OMB Na.205Q 0439 <br /> UNIFORI H OU5 1;rarsarator ID Number 2.Pape 1 of '3.Emergency Rasporise Phone Manffestlftlk_ <br /> WASTEI ANEFEST (:-,c�l.,I3 ?.13 i7 17 i 415-62M772 <br /> 38659 FLE <br /> 5, ratofs Hama end Melling Address _ fator'a, Address(f► 4 ihaii ._. �,.. ......_. <br /> t,ilrft•r td IT ';a,,T RV-,C 'Gfwt%fz�5 AM�ttlllarrl MQnfts-a <br /> `i AI`)'ri F--'l i-t1i`ado St., <br /> *:1e?:'ktrm'GA. <br /> Gansretor's Phone: W9444-9w, <br /> Transporter I Company ma _..,,.,U:S: Att7Num5or _ ... <br /> Union f'auft.Lk&s CO <br /> 7. ranspata< mpany Nama U S:EPAiD Numbs <br /> B.Das{rvatad r0lity New and She Address -U.S.EPAIDNurnbai` <br /> DC �orr1 <br /> i 1 i 1 West Highway 123 VI-091.2201 <br /> Pak Cabm,UT 84520 MA <br /> 9b.U.S.OOT Description(mcluding Proper Ship ft Name,Hazard Class,ID Numt}ar, 10 Contalros 11 Tota! 12.Unit ^.... <br /> 9a, 13.4Yes�Codos <br /> HM and Pacfdng Group(N any)) _ 'tto. '-"-Type' t'2uentity VJllVol. <br /> 1 <br /> RAOUS WASM,S=(Won-WIT f t Rtat jOf ...'- <br /> } <br /> 4, I <br /> , <br /> 14.Spacial HandNng Instructions and AddiBdnWi <br /> W)I-MRA-'z4UWM Reofte <br /> L&�OC PMIMM4116 8406 <br /> 1 <br /> 15, "GENETE R'S1oFFEROR'S CERTIF=710H:I tieraby declare d}a{ , cuhferds o#gs3s era hdry and aceuratefy atiove>ri+the proper thl" 6p iia ne,and ere <br /> Classified <br /> marked and iabelactdplacardad,and are in sit respects In proper condition kx,bmgpprt D 0 apptb&'edafnaWW arxt ndoM governmental regulations,if export shtppint and i am the Primary <br /> Exporter,I certify diet the contents of this cana*nmt corfam to the terms of the attecW ERkA&-wMed n-t of Consent <br /> I cartify that tha waste.mWmW&n statement Identified h40 CFR 26 X(a)(h am s I.ge g�mntity pener'.%or.(b)"(#I tun a sma9 quay*generator)fs fuse. <br /> a n <br /> 1 .�. - <br /> -j 10,International Shlitmntaf--� <br /> p ❑import 0 us, ❑Export frco US. Pat rif antryrexn. <br /> Tran for Date leaft U.S.; <br /> IM <br /> tY_ 17.TrartsgarteaAckrsai�4adgment of Recast of MaterlaH <br /> 171 <br /> ra 1 ypadtiama <br /> F' <br /> Transporter2 atecifryW hIe a re ....r....._ �.. <br /> 18.Discrepancy <br /> ❑Quantty ❑ �Res}due <br /> 16a: Indication ype <br /> on Space ®Pas6al ®FuN ReDecUwr <br /> MwWWRefairerm Number: <br /> .16b:Nternato Facliity(or Gsneretor} <br /> � U,S.EPA1tlNumlik" <br /> Farrl' s Phase: <br /> _._... . _... _ ' . onh , <br /> ay_ year" <br /> Q <br /> 19;Hazardous Waste Rapart Managameat Maiiwd Ccdes(i a.,mde forhezerda»w;ate heatinerit ;"a nd 4cyc5rip systsms) _. <br /> Uj <br /> 1 2 3 .. 4. <br /> 20.Dasfgnabd Faa g{Aanar ar Qpatatar Cartit cation of - _._.,_... <br /> racelpt of hazaMaus niatedats rxrverrsd by-the manifest es nabs m <br /> : ' 1 13 <br /> EPA Form 8700-22(Rev.3.05)Previous editions are obsolete. DESIGNA7ED;FAC1LlTY TO GENERATOR <br />